Go fast, it is good for the heart…

High intensity exercise was in the news today.

Let’s do science: Don’t worry, I will make it easy.
Background: It is known that exercise is good for the heart, even after stents or bypass. Historically, high intensity exercise was too scary to recommend for heart patients. Recently though, reports have suggested that high intensity exercise may not only be safe, but actually better for improving functional capacity and endothelial (blood vessel wall) function.
Remember heart health is all about the inside of the blood vessel – the endothelium. Endothelium was even mentioned in this month’s Velonews.
The study:
Compared two similar groups of patients who underwent stent placement in a previously obstructed artery. Afterwards, one group is assigned to the basic cardiac rehab aerobic exercise and the other gets workouts with a series of one minute high intensity efforts (heart rates to 80-90% of max).
Results: Here is the neat part. After 6 months, the group of patients who did the high intensity intervals had less obstruction at the stent site. Also, and equally important, were that markers of inflammation of the blood vessel were also decreased in the high intensity exercise group.
Take home messages:
As the researchers point out, this study is hypothesis generating and worthy of larger studies with greater statistical power. Do not conclude more than your data allows. A key point. Gives the researchers credibility.
As a competitive cyclist, it is refreshing to see the benefits of our brand of exercise.
We know statins (cholesterol lowering drugs) reduce inflammation in the blood vessel, but now, it is becoming clear that high intensity exercise may also contribute as well. Good for us.
When pondering science, try to fit a studies finding in some “larger” picture and ask, does it make common sense.
The big picture? We humans are still mammalian species. Before civilization, suburbs and drive-throughs we had to survive on our own means. Seemingly, these above noted short bursts of high intensity exertion would have been part of normal life. Those who excelled would be at an evolutionary advantage. Oops, I am treading out on a branch. Just thinking.
Bottom line: Now I can tell my patients to put down those magazines while on the exercise bike, pop in some cool music and get rockin. That is, if I can even get them in the gym.
JMM

2 comments

  1. If you found a difference between the groups, why do you need more power? You had enough this time.

  2. Thanks for reading and writing, Tom.

    It was a small study with only 20 patients in each cohort and was from only one center. Also, endpoints were measurements rather than outcomes. For it to be more generalizable one would want a larger study form multiple centers and include hard outcomes like recurrence of cardiac events, hospitalizations or mortality. It is a great start though. Many motivated patients want to do more without meds.

    JMM

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